Yes / Purpose: Although urgent primary eye care schemes exist in some areas of England, their current safety is unknown. Accordingly, the aim of the present study was to quantify the clinical safety and effectiveness of a COVID-19 Urgent Eyecare Service (CUES) across Luton, Bedford, Hull, East Riding of Yorkshire and Harrogate.
Methods: Consenting patients with acute onset eye problems who had accessed the service were contacted to ascertain what the optometrist’s recommendation was, whether this worked, if they had to present elsewhere and how satisfied they were with the CUES.
Results: 27% (170/629) and 6.3% (28/445) of patients managed virtually and in person, respectively, did not have their acute eye problem resolved. Regression analysis revealed that patients who attended a face-to-face consultation were 4.66 times more likely to be correctly managed (Exp (β) = 5.66), relative to those managed solely virtually. Optometrists phone consultations failed to detect conditions such as stroke, intracranial hypertension, suspected space occupying lesions, orbital cellulitis, scleritis, corneal ulcer, wet macular degeneration, uveitis with macular oedema and retinal detachment. Of referrals to hospital ophthalmology departments, in total, 19% were false-positives. Patients, however, were typically very satisfied with the service. Uptake was associated with socio-economic status.
Conclusion: The present study found that a virtual assessment service providing optometrist teleconsultations was not effective at resolving patient’s acute-onset eye problems. The range and number of pathologies missed by teleconsultations suggests that the service model in the present study was detrimental to patient safety. To improve this, optometrists should follow evidence based guidance when attempting to manage patients virtually, or in person. For example, patients presenting with acute-onset symptoms of flashing lights and/or floaters require an urgent dilated fundus examination. Robust data collection on service safety is required on an ongoing basis. / The full-text of this article will be released for public view at the end of the publisher embargo on 10 Nov 2022.
| Identifer | oai:union.ndltd.org:BRADFORD/oai:bradscholars.brad.ac.uk:10454/18689 |
| Date | 10 November 2021 |
| Creators | Swystun, Alexander G., Davey, Christopher J. |
| Source Sets | Bradford Scholars |
| Language | English |
| Detected Language | English |
| Type | Article, Accepted manuscript |
| Rights | (c) 2022 The Authors, Ophthalmic and Physiological Optics and The College of Optometrists. This is the peer-reviewed version of the following article: Swystun AG and Davey CJ (2022) A prospective evaluation of the clinical safety and effectiveness of a COVID-19 Urgent Eyecare Service across five areas in England. Ophthalmic and Physiological Optics. 42(1): 94-109, which has been published in final form at https://doi.org/10.1111/opo.12916. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions. This article may not be enhanced, enriched or otherwise transformed into a derivative work, without express permission from Wiley or by statutory rights under applicable legislation. Copyright notices must not be removed, obscured or modified. The article must be linked to Wiley’s version of record on Wiley Online Library and any embedding, framing or otherwise making available the article or pages thereof by third parties from platforms, services and websites other than Wiley Online Library must be prohibited., Unspecified |
Page generated in 0.0032 seconds